Sonographically Guided Popliteus Tendon Sheath Injection

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135538/1/jum2010295775.pd

Can Ultrasound Be Used to Improve the Palpation Skills of Physicians in Training? A Prospective Study

BackgroundAccurate diagnosis of musculoskeletal disorders relies heavily on the physical examination, including accurate palpation of musculoskeletal structures. The literature suggests that there has been a deterioration of physical examination skills among medical students and residents, in part due to increased reliance on advanced imaging. It has been shown that knowledge of musculoskeletal anatomy and physical examination skills improve with the use of ultrasound; however, the literature is limited.ObjectiveTo determine whether ultrasound can improve the ability of physicians in training (residents) to palpate the long head of the biceps tendon (LHBT) in the bicipital groove.DesignProspective study design.SettingTertiary care center.ParticipantsTen physical medicine and rehabilitation residents served as subjects. Exclusion criteria included the presence of any condition that precluded their ability to palpate. Three volunteers were used as models. Model exclusion criteria included anything that distorted normal shoulder anatomy or inhibited examiner palpation. Three investigators with experience performing diagnostic musculoskeletal ultrasound were used to confirm palpation attempts.MethodsSubjects attempted to palpate the LHBT bilaterally in the bicipital groove of each model. Investigators assessed the accuracy of the palpation attempt using real‐time ultrasonography. Subjects participated in a 30‐minute ultrasound‐assisted training session learning how to palpate the LHBT in the bicipital groove with ultrasound confirmation. After the ultrasound training session, subjects again attempted to palpate the LHBT in the bicipital groove of each model with investigator confirmation.Main Outcome MeasurementsLHBT palpation accuracy rates preintervention versus postintervention.ResultsPretraining LHBT palpation accuracy was 20% (12/60 attempts). Post‐ultrasound training session accuracy was 51.7% (31/60 attempts; P ≤ .001).ConclusionsOur findings demonstrate that palpation accuracy improves after ultrasound assisted LHBT palpation training. These data suggest that the use of ultrasound may be beneficial when teaching musculoskeletal palpation skills to health care professionals.Level of EvidenceIIPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146948/1/pmr2730.pd

Injury and Illness: An Analysis of Team USA Athletes at the 2024 Winter Youth Olympic Games

BACKGROUND: Injury and illness surveillance is essential for understanding the relative risks of sports participation to develop effective strategies to optimize athlete health, wellness, and performance. Epidemiological studies examining injuries and illnesses among Team USA youth athletes are limited, particularly among athletes competing in Winter sports. The purpose of this study was to characterize the injury and illness incidence rate among Team USA athletes participating in the 2024 Winter Youth Olympic Games (YOG). METHODS: Injuries and illnesses among 101 Team USA youth athletes (40.6% female; age, 17 ± 1 years) were prospectively documented. Injury and illness prevalence, and incidence rate (IR) per 1,000 athlete-days (AD), and incidence rate ratios (IRR) were calculated with accompanying 95% confidence intervals ([95% CI]). RESULTS: Nineteen (18.8%) Team USA athletes reported at least one injury during the 2024 Winter YOG (38.0 [26.1, 53.3] injuries per 1,000 AD). Injury IR was highest among athletes competing in bobsled (166.7 [54.1, 388.9] injuries per 1,000 AD), and overuse was the most common mechanism of injury (17.3 [9.7, 28.5] injuries per 1,000 AD) among all athletes. There were no differences in injury IRs between male and female athletes (IRR [95%CI], 1.6 [0.7, 3.3]), but female athletes reported all time-loss injuries. Ten (9.9%) athletes reported at least one illness (15.0 [8.0, 26.5] per 1,000 AD), with respiratory illness (6%) being the most common type (6.9 [2.5, 15.0] per 1,000 AD). CONCLUSION: This study highlights the need for focused efforts for injury and illness prevention for youth female athletes and athletes participating in high-risk sliding sports. Additionally, consideration for implementation of respiratory illness mitigation measures and load management strategies at and leading up to future competitions for youth athletes is key